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CDC Infection Preventionist Post Test Questions
and Answers with Rationales Latest 202 4.
1. A nurse assistant is about to perform perineal care on an incontinent resident who wears briefs. His supplies have already been gathered and placed on the clean bedside table. He enters the room, dons’ non-sterile gloves, removes and discards the resident's soiled brief and cleans the resident's perineum. He removes his soiled gloves and dons a new pair of non-sterile gloves. He applies a clean brief. He discards his gloves and exists the room. How many times should he have performed hand hygiene in this scenario? Please select the best answer. A) 1 B) 2 C) 3 D) Hand hygiene was not required because gloves were worn. Rationale: The nurse assistant should have performed hand hygiene 3 times in this scenario. First, he should have performed hand hygiene before donning the non-sterile gloves to address the indication before touching a resident. Second, he should have performed hand hygiene after removing his first pair of gloves, before donning the second pair of gloves. This one act would address several indications: After a blood or body fluid exposure; after glove removal; and moving from a dirty task to a clean task. Third, performing hand hygiene after removing the second pair of gloves addresses the indications after glove removal and after touching the resident. (Module 7) 2. A resident is diagnosed with latent TB infection (LTBI). Is there risk that the resident will transmit TB to others in the facility? Please select the best answer. A) No, there is no risk of transmission at this time B) Yes, the resident is very likely to transmit infection to those who are immunocompromised C) No, the resident is not a risk because he/she will be placed in Airborne Precautions D) Yes, the resident is likely to transmit infection to close contacts Rationale: A resident with LTBI has M. tuberculosis in the body but does not have signs or symptoms of TB disease and cannot spread the infection to other people. Airborne Precautions are not required when caring for residents with LTBI. (Module 12b) 3. After you have scored the infection prevention and control (IPC) risk assessment, which of the following actions would you take first to address the findings? Please select the best answer. A) Develop a performance improvement effort B) Identify high-scoring items for IPC program prioritization C) Develop new (or review existing) IPC policies and procedures D) Provide education and training for staff Rationale: The first step would be to identify the high-scoring items for IPC program prioritization. Subsequent actions to address high-scoring items might include developing a performance improvement
effort, developing or reviewing IPC policies and procedures, or providing education and training for staff. (Module 1)
4. As a result of lessons learned from outbreaks of multidrug-resistant organisms (MDROs) in nursing homes, which of the following situations should warrant use of Contact Precautions and consideration of a single- person room for MDRO-colonized residents? Please select all that apply. A) Residents with difficulty containing secretions from sites of MDRO colonization and potential for extensive environmental contamination B) New residents on the unit are found to be colonized with the MDRO (evidence of ongoing transmission) despite efforts to control spread C) Residents with minimal medical or nursing care needs who are able to move independently throughout the facility D) Residents receiving antibiotics Rationale: Nursing homes should implement Contact Precautions with consideration of single-person rooms for MDRO colonized residents when there is difficulty containing secretions from sites of colonization that could result in extensive environmental contamination and when there is evidence of ongoing transmission despite efforts to control spread of an MDRO. While Enhanced Barrier Precautions might be considered during high contact care activities for certain residents with risk factors, regardless of MDRO colonization status, highly independent residents or those receiving antibiotics would not warrant Contact Precautions even if MDRO colonized without those characteristics. (Module 6b) 5. At what stage of an investigation would you notify local or state public health officials that you have an outbreak? Please select the best answer A) Once an outbreak case definition has been developed B) Once an outbreak has not been controlled by infection prevention and control (IPC) measures C) Once an outbreak has been determined to exist D) Once an outbreak has been evaluated and summarized in a written report Rationale: A facility should notify local or state public health officials as soon as an outbreak has been determined to exist. (Module 5) 6. Before performing wound care, if the hands are not visibly soiled, which method of hand hygiene by staff members is preferred? Please select the best answer. A) Using an alcohol-based hand rub B) Washing hands with soap and water, followed immediately by use of an alcohol-based hand rub C) None. Since gloves should be worn when performing wound care, hand hygiene is not necessary D) None of the above Rationale: Alcohol-based hand rub is the preferred method of hand hygiene in most clinical situations, including this scenario. Soap and water should be used if hands are visibly soiled. If hand hygiene is performed with soap and water, it is not necessary to then immediately use an alcohol-based hand rub. Hand hygiene should be performed before touching a resident, even if gloves will be worn. (Module 7) 7. During January, there were five residents with central venous catheters (CVCs) for a total of 100 catheter-days. There were 4,000 resident-days for the month. There were two central line- associated blood stream infections (CLABSIs) identified. What is the CLABSI rate for the month?
Rationale: When calculating an infection rate, the denominator represents the population at risk for the event during the timeframe defined for surveillance. Because only residents with a CVC can experience a CLABSI, the correct denominator only counts the days when residents had the device. In this example, the denominator would be 100 catheter-days. The numerator is the total number of CLABSIs occurring during the timeframe of interest. In this example, there are two CLABSIs. A constant, k, of 1,000 is used to standardize the rate. Therefore, the CLABSI rate calculation is two events divided by 100 catheter-days multiplied by 1,000, which equals 20 CLABSIs per 1,000 catheter-days. (Module 4)
8. During the previous influenza vaccine season, 120 residents received the influenza vaccine. 80 residents declined the vaccine. Which of the following is the correct resident influenza vaccination acceptance rate? Please select the best answer. A) 40 percent B) 60 percent C) 67 percent D) 80 percent Rationale: For process measure surveillance, the numerator represents the number of individuals adherent to a practice, and the denominator represents the number of opportunities to perform the practice. In this example, the numerator is 120, or the number of residents who received the influenza vaccine. The denominator is the total number of residents eligible to receive the vaccine, which is 200 ( residents who received the vaccine plus 80 residents who declined it). The vaccine acceptance rate calculation is 120 divided by 200 multiplied by 100, which equals 60 percent. (Module 4) 9. During which of the following situations should a gown be considered in addition to gloves during care of a resident with an indwelling urinary catheter? Please select the best answer. A) As a strategy to prevent spread of multidrug-resistant organisms (MDROs) when handling the indwelling urinary catheter B) If there is potential for splash or spills when emptying a collection bag C) To prevent spread of pathogens during care of residents placed in Contact Precautions D) All of the above Rationale: Given the risk of MDRO colonization of medical devices, use of a gown should be considered in addition to gloves as a strategy for preventing spread of MDROs when handling indwelling urinary catheters. Gowns should be worn if there is potential for splash or spills when emptying a urinary collection bag as part of Standard Precautions and used to prevent spread of pathogens during care of residents placed in Contact Precautions. (Module 6b) 10. For residents admitted to a nursing home on a course of antibiotics started in a hospital, which pieces of information would be important to know? Please select the best answer. A) Indication for the antibiotic course B) Dose of the antibiotic C) Duration of the antibiotic course D) All of the above Rationale: Important antibiotic use information for receiving providers includes the indication, dose and schedule, and duration of the antibiotic course. (Module 14)
11. For which of the following organisms and syndromes should you apply Contact Precautions? Please select all that apply. A) Pneumococcal pneumonia B) Scabies C)Tuberculosis D)Clostridioides difficile Rationale: Contact Precautions should apply when caring for residents with scabies infestations or Clostridioides difficile infection. Standard Precautions should be used when caring for residents with pneumococcal pneumonia. Airborne Precautions should be used when caring for residents with tuberculosis disease. (Module 6b) 12. In residents with central venous catheters (CVCs), which of the following factors increase the likelihood of developing a bloodstream infection? Please select the best answer. A) Higher number of lumens B) Shorter duration of placement C) Smaller number of lumens D) Use of implanted device (e.g., port) Rationale: A higher number of lumens increase the likelihood of developing a bloodstream infection in residents with a CVC. Shorter duration of placement and use of an implanted device decrease the likelihood of developing a bloodstream infection. (Module 10b) 13. Missing or inadequate information exchanged during care transitions can result in which of the following. Please select all that apply. A) Unrecognized spread of resistant bacteria at accepting facility B) Appropriate duration of antibiotic courses for transferred residents C)Increased risk of antibiotic-related adverse events D)Increased recognition of outbreaks Rationale: Missing or inadequate information exchanged during care transitions can increase the risk of unrecognized spread of resistant bacteria at accepting facilities; it can also increase the risk of antibiotic - related adverse events and other harms from inappropriate use. Efforts to improve antibiotic use and duration and the recognition of outbreaks from pathogens diagnosed after a care transition only happen with improvement in communication processes. (Module 15) 14. Removing a central venous catheter (CVC) that is no longer indicated most directly disrupts which part of the chain of infection? Please select the best answer. A) Source B) Portal of exit C) Portal of entry D) Mode of transmission
15. Nurse Amy is about to perform a dressing change. The wound needs to be irrigated with large amounts of normal saline. Which of the following personal protective equipment (PPE) should Amy wear?? Please select all that apply A) Gown B) Face protection (mask and goggles, or face shield) C)Respirator D)Gloves Rationale: Gloves, a gown, and face protection should be worn in this wound care scenario to minimize cross-contamination of hands and clothing while positioning the resident and protecting the wound care nurse from splash or aerosols that could be generated during wound irrigation. A respirator would not typically be worn when irrigating a wound. (Module 10c) 16. Standard Precautions apply when caring for which of the following residents? Please select the best answer. A) All residents known to be colonized with antibiotic-resistant bacteria B) All residents who require maximal assistance with activities of daily living C) All residents, regardless of suspected or confirmed infection status D) All residents with wounds, indwelling devices, or who are receiving antibiotics Rationale: Standard Precautions are a group of IPC practices that apply to all patients and residents, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered. While Standard Precautions should also apply when caring for the residents described in answers A, B, and D, C is the best answer. (Module 6a) 17. Tracking process and outcome surveillance measures over time allows the infection prevention and control (IPC) program to do which of the following? Please select the best answer. A) Establish a baseline rate B) Identify changes in rates that may require an intervention C)Understand whether an intervention is effective D)All of the above Rationale: Tracking process and outcome surveillance measures over time allows you to establish a baseline rate for the measure being tracked. This will then allow you to identify changes in the rate, such as an increase in infection events or decrease in staff adherence to IPC practices, that might warrant an intervention. Once an intervention is implemented, you can then follow the rate to see if it is making an impact. (Module 4) 18. As part of Respiratory Hygiene and Cough Etiquette, individuals with signs of respiratory infection should wear a facemask, if tolerated. A) True
B) False Rationale: Source control measures described in Respiratory Hygiene and Cough Etiquette include having individuals with signs of a respiratory infection wear a facemask. (Module 9)
19. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule restricts healthcare providers from sharing protected health information at transfer for treatment purposes without patient authorization. A) True B) False Rationale: The HIPAA Privacy Rule permits healthcare providers to share protected health information for treatment purposes without the authorization of the patient. (Module 15) 20. What are examples of source control measures to contain respiratory pathogens? Please select all that apply. A) Place a facemask on individuals with signs of respiratory infection B) Cough into the hands C) Prompt disposal of used tissues D) Hand hygiene after contact with respiratory secretions Rationale: Source control measures to contain respiratory pathogens include: Placing a facemask on individuals with signs of respiratory infection; promptly discarding used tissues in the nearest waste container; and performing hand hygiene after having contact with respiratory secretions. Coughing into hands is not a recommended source control measure. The recommended practice is to cover the mouth and nose with a tissue when coughing or sneezing, or coughing into the elbow or upper arm, instead of hands, if tissues are not available. (Module 9 21. What information should NOT be included on signage at room entry communicating that resident has been placed on Transmission-Based Precautions?? Please select the best answer. A) Resident diagnosis B) Category of precautions C) Personal protective equipment (PPE) required for staff caring for the resident D)Instructions for visitors Rationale: Signs placed at room entry to communicate when a resident has been placed on Transmission-Based Precautions should include information about the category of Precautions (for example, Contact or Droplet); what PPE staff should use when caring for the resident; and instructions for visitors. Signs should NOT identify the specific indication for precautions or any other personal health information that might violate privacy or resident dignity. (Module 6b) 22. What is the most important reason to monitor your infection surveillance data before an outbreak occurs? Please select the best answer. A) To establish baseline infection rates
C) To facilitate reporting outbreaks to public health authorities D) None of the above Rationale: The most important reason to monitor infection surveillance data is to establish baseline infection rates for your facility. The baseline can serve as a standard for comparison to demonstrate changes in infection outcomes or IPC practices. Increases in infection rates over the baseline can serve as a signal to investigate a potential outbreak in the facility. Surveillance data is useful for detecting outbreaks but generally does not predict where an outbreak will occur in the future. (Module 5)
23. What is the primary purpose of the facility infection prevention and control (IPC) risk assessment? Please select the best answer. A) To demonstrate regulatory adherence B) To discuss at resident council meetings C) To assist with developing optimal strategies for financial reimbursement D) To set priorities and goals for preventing infections and improving resident outcomes Rationale: The primary purpose of the facility IPC risk assessment is to set priorities and goals for preventing infections and improving resident outcomes. (Module 1) 24. What steps should be taken to prevent contamination of wound care supplies? Please select all that apply. A) Store supplies on a clean treatment cart and bring cart into resident rooms as needed B) Select and gather necessary wound care supplies for use on a resident prior to entering the resident care area C) Dedicate topical medications to a single resident D) Return unused, disposable supplies that entered the resident care area to the clean supply cart Rationale: Strategies to prevent contamination of wound care supplies include dedicating topical medications to a single resident and selecting and gathering all supplies needed for wound care prior to entering the resident care area. Clean treatment carts used to store supplies should not enter resident rooms or treatment areas. Unused disposable supplies that enter the resident care area should not be returned to the clean supply cart; instead, they should remain dedicated to that resident or be discarded. (Module 10c) 25. When caring for a resident with an indwelling urinary catheter, which of the following maintenance practices are appropriate? Please select all that apply. A) The periurethral site should be scrubbed with antiseptic on a daily basis B) The urinary catheter should be checked for kinks and obstructions in flow C) The urine collection bag should be placed on the floor at night D) The urine collection bag should be secured below the level of the bladder
Rationale: The flow of urine from the catheter should be unobstructed, and the catheter tubing should be checked for kinks. The urinary collection bag should be secured below the bladder and never allowed to
to accept and care for a resident with TB disease. (Module 12b)
29. Which of the following are appropriate indications for indwelling urinary catheters? Please select all that apply. A) Managing prolonged immobilization for pelvic fracture B) Managing incontinence in a resident with a healed sacral wound C) Managing incontinence in a resident with risk of falls D) Managing acute urinary retention Rationale: Appropriate indications for use of an indwelling urinary catheter include: To relieve acute urinary retention or bladder outlet obstruction; to promote wound healing and prevent wound contamination in an incontinent resident with open sacral or perineal wounds; to manage prolonged immobilization due to conditions use as an unstable spine or pelvic fracture; and as a comfort measure during end-of-life care. Indwelling urinary catheters should not be used solely for the management of incontinence and can increase the risk of falls. (Module 10a) 30. Which of the following are core activities of an infection prevention and control (IPC) program? Please select all that apply. A) Identifying, recording, and correcting IPC incidents B) Developing policies and procedures to prevent resident falls C) Conducting an annual review and update based on the IPC risk assessment D)Performing infection surveillance Rationale: The core activities of an IPC program include all of the following: developing and implementing IPC policies and procedures; identifying, recording, and correcting IPC incidents; performing infection surveillance; investigating and reporting communicable diseases; conducting an annual review and update based on the IPC risk assessment; and establishing an antibiotic stewardship program. Preventing resident falls is not a focus of the IPC program. (Module 1) 31. Which of the following are elements of aseptic technique? Please select the best answer. A) Preparing injections in close proximity to a sink B) Storing needles and syringes outside of their protective packaging C) Leaving a needle inserted into the septum of the medication vial when preparing injections D)Preparing injections as close as possible to the time of administration Rationale: Preparing injections as close as possible to the time of administration is an element of aseptic technique. Preparing injections in close proximity to a sink, storing needles and syringes outside of their protective packaging, and leaving a needle inserted into the septum of a medication vial when preparing injections are practices that increase the risk of contamination. (Module 8) 32. Which of the following are examples of how the Quality Assessment and Assurance (QAA) Committee might support the infection prevention and control (IPC) program? Please select the best answer. A) Approves a cleaning and disinfecting procedure revised to address practice gaps following an outbreak
D)CVC dressings should be labeled with the date of dressing change
Rationale: CVC dressing integrity should be assessed daily, and the dressing should be labeled with the date of last dressing change. Transparent, semipermeable dressings should be changed every 5 - 7 days, and gauze dressings should be changed every 2 days. While many nursing staff may be able to assess the integrity of a CVC dressing, only trained staff with demonstrated competency should perform CVC dressing changes. (Module 10b)
36. Which of the following are true about placement within the facility of residents on Transmission - Based Precautions? Please select the best answer. A) If an airborne infection isolation room (AIIR) is not available, a resident with tuberculosis can remain in a single-person room with the door closed for the duration of their treatment. B) If a limited number of single-person rooms are available, highest priority should be given to residents who are known or suspected to be infected with highly communicable pathogens. C) If not enough single-person rooms are available, then it is best to spread residents on precautions throughout the facility to keep infected residents from congregating. D) If a resident on Transmission-Based Precautions remains in a shared room, the equipment in the room should be dedicated to both the resident and his roommate. Rationale: When a limited number of single-person rooms are available, the highest priority should be given to residents that are known or suspected to be infected with highly communicable pathogens. Residents with tuberculosis should be transferred out of the facility if there is not an AIIR room available in the facility. If not enough single-person rooms are available, then co-horting, or grouping residents colonized or infected with the same organism into rooms together, can limit exposure to other residents and staff in the facility. Residents on Transmission-Based Precautions in a shared room should be given dedicated equipment to limit indirect contact transmission to roommates. (Module 6b) 37. Which of the following are ways that tuberculosis (TB) is transmitted? Please select the best answer. A) Through contact with medical equipment that was not properly cleaned B) Through soiled linens of an infected resident C) Through small infected particles suspended in the air D) All of the above Rationale: TB is only spread through the airborne route, and it is not transmitted by direct or indirect contact. TB cannot be spread by touching a person or handling their clothing, linens, or care equipment. (Module 12b) 38. Which of the following best describes an "antibiotic time out"? Please select the best answer. A) Taking the resident off all medicines for 2 - 3 days before administering the antibiotic B) Reassessing treatment 2 - 3 days after starting antibiotic therapy, taking into account lab results and clinical response C) Stopping antibiotic administration after 2 - 3 days D) None of the above
39. Which of the following describes ways that wounds increase the risk of infections and pathogen transmission in nursing homes? Please select the best answer. A) Provide a portal of entry for pathogens B) Provide a surface for biofilm formation C) Provide a reservoir for multidrug-resistant organism (MDRO) colonization D) All of the above Rationale: The presence of wounds increases the risk of infections and pathogen transmission by providing a portal of entry, providing a surface for biofilm formation, and creating a reservoir for MDRO colonization. (Module 10c) 40. Which of the following factors should be considered when selecting a low- or intermediate-level disinfectant for use in your facility? Please select all that apply. A) Manufacturer of the disinfectant B) Contact time C) Pathogens against which the disinfectant is effective D) Compatibility of the product with common surfaces and equipment in the facility Rationale: Contact time, pathogens against which the disinfectant is effective, and compatibility of the product with common surfaces and equipment in the facility are all factors that should be considered when selecting a low- or intermediate-level disinfectant for use in the facility. The manufacturer of the disinfectant would not be an important factor. (Module 11a) 41. Which of the following in a resident room should be cleaned and disinfected on a daily basis? Please select all that apply. A) Bedrails B) Window sills C)Toilet D)Call buttons Rationale: High-touch surfaces in resident rooms should be cleaned and disinfected on a daily basis. Bedrails, surfaces around the toilet, and call buttons are examples of high-touch and frequently contaminated surfaces. Horizontal surfaces with infrequent hand contact, like window sills, should be cleaned on a regular basis, when spills occur, and if the surfaces become visibly soiled. ( Module 11b) 42. Which of the following is a best practice for policy development? Please select all that apply. A) Revise policy when standards or practices change B) Allow staff review and feedback C) Review every five years for clinical relevance D) Use facility staff opinion as the primary source for policy development
Rationale: Revising policies when standards or practices change and incorporating staff feedback as part of the process are best practices in developing policies. Policies should be reviewed every year for clinical relevance as part of the IPC program annual review and should incorporate current standards of practice based on nationally recognized, evidence-based guidelines. Staff opinion should not be used as the primary source for policy development. (Module 1)
43. Which of the following is an example of how the infection preventionist (IP) acts as a collaborator? Please select the best answer. A) Helping the dietary department prepare meals when they are short staffed B) Working with the environmental services (housekeeping) staff to improve work flow for terminal room cleaning C) Dining with residents when family members are unable to come in for a visit D) None of the above Rationale: Collaboration in the role of the IP includes building consensus and engaging internal experts. Working with the environmental services (housekeeping) staff to improve workflow for terminal room cleaning is an example of collaboration. (Module 2) 44. Which of the following is NOT a goal of a water management program? Please select the best answer. A) Identifying potential hazards to water quality B) Sterilizing municipal water C) Implementing controls to minimize growth and spread of waterborne pathogens D) Reducing risk of water-related outbreaks and infections Rationale: Water management programs are designed to identify water quality hazards, implement controls to minimize the growth and spread of waterborne pathogens, and reduce the risk of water-related infections. Municipal water is not sterile and sterilization of municipal water is not a goal of a water management program. (Module 11c) 45. Which of the following is NOT a mode of transmission for group A Streptococcus? Please select the best answer. A) Direct contact B) Indirect contact C)Droplet D)Airborne Rationale: The modes of transmission for group A Streptococcus include: Direct and Indirect contact and Droplet transmission. Group A Streptococcus is not spread by the airborne route. (Module 6a)
